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General NPI Number Information
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NPI Number | 1538612593
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Entity Type | Individual
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Provider Name | MARGARET DEROSA NP
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Gender | Female
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 7704 MATAPEAKE BUSINESS DR STE 200
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City | BRANDYWINE
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State | MD
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Zip | 20613-3045
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Country | US
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Telephone | 301-812-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 7704 MATAPEAKE BUSINESS DR STE 200
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City | BRANDYWINE
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State | MD
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Zip | 20613-3045
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Country | US
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Telephone | 301-812-3900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC001916
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License Number State | MD
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